Anyone who suffers from chronic conditions is probably familiar with shuffling between doctors appointments and receiving care from more than one provider. Any lack of coordination between providers is frustrating, if not expensive; repeat testing, slow processing time of paperwork, or having your medical records spread out across several clinics can decrease both the efficiency and the quality of care provided.
It’s no surprise then that more patients and doctors alike are seeking to establish interdisciplinary, coordinated care for patients with chronic conditions. Despite the growth in coordinated care, older adults with back pain continue to receive uncoordinated treatments, with care doled out separately by medical doctors, chiropractors, physical therapists, and other healthcare providers. In effort to improve co-management of musculoskeletal conditions in seniors, a team of researchers recently studied 48 older patients with back pain. The patients participated in 10 focus groups that sought to collect their perspectives and opinions on back-pain treatment.
Chiropractors were the most common provider seen for back pain (69%), reflecting earlier research demonstrating the popularity of chiropractic for older adults. Sixty percent of participants had seen a medical doctor for their pain, 38% had visited a physical therapist, 17% had seen an osteopath, and 8% had received massage therapy. Although medical doctors and doctors of chiropractic were the most common providers in treating back pain, the majority of participants said their doctors did not coordinate care or provide treatment concurrently. Despite the fact that referrals did occur among doctors, the patients were unaware of any additional communication among different clinics.
Participants agreed that co-management could be a positive approach for back pain treatment, and believed that DCs and MDs should consult with one another regularly. Perceived barriers to co-management included the potential costs associated with seeing multiple providers and transportation issues. However, earlier research has suggested that chiropractic care may actually lower patient medical costs by preventing the use of unnecessary testing and procedures. Improving communication between DCs and MDs could help to prevent repeat diagnostic testing or other costs.
Integrating chiropractic into the medical treatment of back pain could also improve treatment outcomes. Another recent study examined the outcomes of patients with back pain treated with either a combination of chiropractic and medical care or medical care alone. Those who received chiropractic treatments had greater reductions in disability and pain compared to the medical-care only group. Whether you’re an older adult or are simply suffering from chronic back pain, consider consulting with your chiropractor or MD about co-management.
Lyons KJ, et al. Perspectives of older adults on co-management of low back pain by doctors of chiropractic and family medicine physicians: a focus group study. BMC Complementary & Alternative Medicine 2013; 13(225).
Goertz C, et al. Adding chiropractic manipulative therapy to standard medical care for patients with acute low back pain: Results from a pragmatic randomized comparative effectiveness study. Spine 2013; 38 (8): 627–634. doi: 10.1097/BRS.0b013e31827733e7.